Tag Archives: heart disease

What you need to know about your heart.

February is American Heart Month, with a focus on encouraging all of us to make heart-healthy choices to reduce cardiovascular disease risk. I thought that sharing some information about the heart, how it works, and how to keep it healthy would be an appropriate way to celebrate. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

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The not-so-sweet truth about sugar and your health.

You are probably aware that eating too much sugar is bad for your health. Excessive sugar intake causes hormonal changes and inflammation that can lead to obesity, diabetes, heart disease, and cancer. For decades an emphasis was placed on lowering fat intake, especially saturated fat and cholesterol, to reduce the risk of obesity and heart disease.

Unfortunately, much of this advice was misguided and while fat intake went down, sugar consumption in processed and prepared food increased. This is now seen as a primary cause of the current obesity and diabetes epidemic. The impact of sugar on health and steps you can take to reduce sugar intake are the topic of my Health & Fitness column in the Aiken Standard this week.

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Exercise, when you need it most

Regular exercise is one of the most important things you can do for your health. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of exercise. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing. Exercise is essential for development of children, maintaining health in adults, and can even reverse some of the effects of aging.

Despite these clear benefits, many people do not participate in regular exercise until they have a medical condition, like a heart attack or cancer, that motivates them to start.  This is the topic of my Health & Fitness column in the Aiken Standard this week.

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It is well-known that people who exercise have a lower risk of heart attack and improved survival if they do have one. While immediate treatment of a heart attack using medications and surgery is critical, the truth is that the long-term outcomes are largely based on what happens next. Traditionally, heart disease patients were told to rest and not stress their hearts, a belief that many still hold today. Now we know that exercise-based cardiac rehabilitation programs are key to improving heart health and preventing future complications.

Most cardiac rehabilitation programs include several phases that include monitored exercise, education about nutrition, weight control, stress management, proper medication use, and psychosocial wellbeing. The benefits of cardiac rehabilitation are well-established through research and practice. In fact, many patients credit cardiac rehabilitation with saving their lives, even if they had bypass surgery. Despite this, less than a third of patients who are eligible for cardiac rehabilitation actually attend a program.

Exercise is also known to reduce the risk of developing certain types of cancer, including breast, colon, bladder, lung, kidney, and endometrial cancers. This is due to the fact that exercise causes changes at the cellular and hormonal level that result in reduced inflammation and improved immune system function. Regular physical activity can also improve survival and reduce the risk of recurrence of cancer.

In addition to helping reduce the risk of cancer development and recurrence, regular exercise can help you handle cancer treatment better. To be sure, cancer treatment can lead to extreme physical consequences including loss of weight, muscle mass, strength, and endurance. At least some of this is due to more time resting and less time being active, the effects of which occur within days and get worse over time.

The fitter you are when you begin treatment, the fitter you will be at the end because you have “saved” more strength and endurance in your fitness bank. You simply have more you can lose before you get to a point at which you can’t complete your normal activities. And post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and rebuild strength, endurance, and feelings of wellbeing.

Another benefit of cardiac rehabilitation and cancer exercise programs is the support from other heart attack and cancer survivors. Combined with support from medical professionals, family, and friends, these groups become an essential resource for information, comfort, and encouragement.

If you or someone you know has had a heart attack, heart surgery, or a cancer diagnosis, encourage them to ask their doctor about an appropriate exercise program—it is likely to be the best way to improve quality of life. In our area, there is a cardiac rehabilitation program based at the USC Aiken Wellness Center as well as at several hospitals in Augusta. There is also an exercise program for cancer survivors called Livestrong at the YMCAs in Aiken, North Augusta, and Augusta.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

Your Heart Month action plan

Heart disease, sometimes called coronary artery disease, is the leading cause of death in the United States. Despite improvements in prevention, diagnosis, and treatment, it is still responsible for nearly 600,000 deaths each year, mostly from heart attacks. Millions more are at increased risk because of certain biological and behavioral risk factors. Some of these risk factors cannot be changed, such as age, sex, and family history, while others can be altered to reduce risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity. You can learn much more about heart disease from the American Heart Association.

Since February is Heart Month, this is an ideal time to assess your own risk of heart disease and take steps to improve your heart health. If you aren’t sure where to begin, my Health & Fitness column in the Aiken Standard this week includes four simple steps you can take to assess and lower your risk for heart disease. If you aren’t sure where to begin, these four steps should be a good start to prevent and treat heart disease.

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Here is your Heart Month action plan:

  1. Assess your risk. If you haven’t done so recently, you should see your doctor to have your risk factors evaluated. This includes tests for blood glucose and blood lipids (including total, LDL, and HDL cholesterol and triglycerides), measurement of your blood pressure and body weight, and an assessment of other health factors such as your family history, whether you smoke, and your level of physical activity. You may be able to find a health fair or other event in the community at which you can have many of these measurements made, but only your doctor can help you determine the best course of treatment given your personal risk profile.
  1. Be active everyday. The benefits of as little as 30 minutes per day physical activity are well-established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, that can have such a broad impact on reducing heart disease risk!
  1. Improve your diet. If you are like most Americans, your diet is too high in unhealthy fats, salt, and added sugar and lacking adequate whole grains, fruits and vegetables, and fiber. This type of diet is associated with obesity, high blood pressure, high cholesterol, and diabetes. All of these conditions are risk factors for heart disease, so you may literally be eating your way to a heart attack. Changing what you eat to include more whole grains, fruits, vegetables, and low-fat meat and dairy and minimizing added sugars, fat, and processed foods can help you lose weight and prevent or treat high cholesterol, diabetes, and high blood pressure.
  1. Quit smoking. There is no way around this one—quit! Ask your doctor about prescription medications that can make quitting easier. Nicotine replacement therapy in the form of patches, gum, and lozenges can help manage cravings and are available over the counter. Ultimately, though, quitting smoking is a behavior change that takes motivation, willpower, and time. But it is worth it—your risk of heart attack goes down within days and can drop 50–70% within five years after quitting.

The potential impact of these steps is great. Knowing which risk factors are most concerning can help you and your doctor make the most effective treatment decisions. Even modest changes in diet and activity can lead to improvements in risk factors and reduced heart attack risk. The best news is that you can start today by putting down your next cigarette, going for a walk, and eating a healthier dinner. Your heart will be glad you did.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

 

Don’t wait until you get sick: What you can do to prevent heart disease.

I have been writing recently about heart disease, how it is diagnosed, and what you and your doctor can do to treat it. In order for your doctor to start treating you for heart disease risk factors such as high blood pressure, high cholesterol, or diabetes you need to be diagnosed with one of these conditions. This requires proactively seeing your physician for screening before you start experiencing the consequences of these conditions.

But most people don’t visit their doctor until they have symptoms, and many wait until a more serious event (a heart attack, for example) occurs to seek medical attention. By this time, the disease process has progressed and managing it becomes the goal. It is possible to prevent both the conditions that lead to heart disease as well as reduce the risk that you may have a heart attack or stroke.

Your risk of heart disease is largely determined by health-related attributes and behaviors called risk factors. Some of these risk factors cannot be changed, including age, sex, and family history. Other risk factors are modifiable, meaning you can change them to reduce your risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity.

While there are medications that can lower blood pressure and cholesterol and treat diabetes, these modifiable risk factors are best addressed by lifestyle changes. Adopting healthy habits has the potential to have a bigger effect on heart attack risk than medical management. There are three important health behaviors that, together and separately, have a powerful effect on reducing heart attack risk:

Stop smoking. There is no way around this one. Quit! Ask your doctor about prescription medications that can make quitting easier. Nicotine replacement therapy in the form of patches, gum, and lozenges can help manage cravings and are available over the counter. Ultimately, though, quitting smoking is a behavior change that takes motivation, willpower, and time. But it is worth it—your risk of heart attack can drop 50–70% within five years of quitting.

Be active everyday. The importance of physical inactivity as a risk factor for heart disease is often overlooked. But make no mistake, being active on a regular basis is one of the most important things you can do to improve your heart health. Whether you have other risk factors or not, physical activity can reduce your chance of having a heart attack. And if you do have a heart attack, your active lifestyle improves your chances of survival and returning to a normal lifestyle.

The benefits of exercise are well-established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, that can have such a broad impact on heart disease risk!

Improve your diet. If you are like most Americans, your diet is too high in saturated fat, salt, and added sugar and lacking adequate whole grains, fruits and vegetables, and fiber. This type of diet is associated with obesity, high blood pressure, high cholesterol, and diabetes. All of these conditions are risk factors for heart disease, so you may literally be eating your way to a heart attack.

It turns out that adopting a healthier eating pattern is important in reducing your risk of heart disease. Saturated fat intake can lead to abnormal blood lipids and high salt intake is linked to high blood pressure. While eating sugar doesn’t cause diabetes, the type of diet described above is associated with weight gain and diabetes. Just like with physical activity, a healthy diet can lead to improvements in several other risk factors.

The potential impact of these three health behaviors is great. Even modest changes in diet and activity can lead to improvements in risk factors and reduced heart attack risk. More intensive lifestyle modification can produce even greater benefits. In one famous study, daily exercise, a low-fat vegetarian diet, and stress management actually caused regression of heart disease, meaning that the blockages in the coronary arteries were smaller following treatment. While you may not follow such a strict program, becoming more active, eating a healthier diet, and quitting smoking can go a long way to improving your heart health.

What your doctor may do to diagnose and treat heart disease, and what YOU should do

As Heart Month draws to a close, it’s worth understanding a bit more about the tools your doctor may use to diagnose and treat heart disease or a heart attack. And, equally important, what you can (and should) do if you have a heart attack help prevent it from happening again.


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Coronary artery disease or heart disease is caused by atherosclerosis, a process which involves the accumulation of cholesterol plaques in the arteries that supply blood to the heart. These plaques can narrow the blood vessels and reduce blood and oxygen delivery to the heart, leading to symptoms like chest pain (ischemia). The plaques can also rupture and form a blood clot, blocking oxygen delivery and causing a myocardial infarction—a heart attack.

If you experience symptoms such as chest pain or have a high risk of heart disease due to family history and other risk factors, your doctor may recommend a diagnostic test. In a graded exercise test (GXT), or “stress” test, a person exercises, typically walking on a treadmill, at increasing speed and grade while heart rate, blood pressure, and heart rhythm are monitored by a doctor or exercise physiologist.

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Changes in these variables, as well as the person’s exercise capacity, can be signs of ischemia and heart function. Often, a GXT is combined with another diagnostic technique such as nuclear imaging, which shows areas of the heart that do not receive enough blood flow, or an echocardiogram that uses ultrasound to show the heart beating and ejecting blood.

Based on the GXT results a cardiologist may recommend an angiogram, in which a catheter is inserted into an artery and threaded into the coronary arteries, dye is injected, and the coronary arteries are viewed through X-ray imaging. This allows cardiologists to actually see the extent of the narrowing in the coronary arteries.

You can been diagnosed with heart disease based on the results of an angiogram or if you had a heart attack. During the angiogram a cardiologist can perform an angioplasty in which a balloon catheter is inflated to open narrowed arteries. A mesh stent may also be placed to help keep the vessel open for longer. In other cases coronary artery bypass surgery may be indicated. Considered open heart surgery, this procedure actually bypasses narrowed sections of coronary arteries using another vessel, typically a leg vein. Both angioplasty and bypass surgery can restore adequate blood flow to the heart and treat ischemia and heart attacks.

Many people consider the treatment complete after the heart attack has ended and the angioplasty or bypass surgery is complete. The truth is that the long-term outcomes are largely based on what happens next. Traditionally, heart disease patients were told to rest and not stress their hearts, a belief that many still hold today. But exercise-based cardiac rehabilitation programs are key to improving heart health and preventing future complications.

Most cardiac rehabilitation programs include several phases. Phase I programs start in the hospital and focus on getting out of bed and performing self-care activities and some walking. Phase II cardiac rehab involves closely-monitored exercise, usually for 12 weeks following a heart attack or surgery. Phase III involves longer exercise sessions with greater independence and transitions into Phase IV, a lifelong exercise program. Education about exercise, nutrition, weight control, stress management, proper medication use, and psychosocial wellbeing are essential in all phases of cardiac rehabilitation.

The benefits of cardiac rehabilitation are well-established through research and practice. In fact, many patients credit cardiac rehabilitation with saving their lives, even if they had bypass surgery. Despite this, less than a third of patients who are eligible for cardiac rehabilitation actually attend a program.

If you or someone you know has had a heart attack or surgery, encourage them to ask their doctor about cardiac rehabilitation—it is likely to be the best way to improve quality of life and avoid future heart problems.

Numbers you need to know to prevent and treat heart disease.

February is American Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. When it comes to heart disease, there are several numbers, including your blood pressure, cholesterol, and glucose, you (or your doctor) may be monitoring. But there is another set of numbers that are equally important for preventing and treating heart disease that you may not be familiar with: 0, 5, 10, 25, and 30.

What these numbers mean and why they are so important is the topic of my Health & Fitness column in the Aiken Standard this week.


 

Blood test results

0 is for no smoking. Cigarette smoking more than doubles your risk of heart disease and stroke, is by far the leading cause of lung cancer and other lung diseases, and is responsible for over 400,000 deaths per year. If you smoke, quitting now is one of the most important things you can do to improve your health. Nicotine replacement therapy in the form of gum, lozenges, and patches as well as prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and some benefits of quitting can be realized almost immediately.

5 is for eating five fruits and vegetables each day. A healthy diet is one important aspect of good health. While there is no one single measure of a healthy diet, adequate fruit and vegetable consumption is widely considered to be essential for good health. Fruits and vegetables contain vitamins, minerals, and fiber and most are low in calories. At a minimum, you should eat five servings per day with an emphasis of fresh fruits and vegetables. Your real goal should be to include fruits and vegetables in all meals and snacks, but five servings per day is a good start.

10 is for 10,000 steps per day. Regular physical activity is essential for good health. Almost any activity counts, and a good goal is to be as active as possible throughout the day. You can track your physical activity using a pedometer (step counter) or an app on your phone. A target of 10,000 steps per day is a commonly cited goal, but you should try to take as many steps as possible. You can do this by minimizing the time you spend sitting, taking the stairs instead of the elevator, and walking instead of driving when possible. More steps are better, even if you don’t get to 10,000.

25 is for maintaining a healthy body weight, or a body mass index (BMI) of less than 25. The BMI is a measure of weight relative to height. A BMI of 18–25 is considered healthy, 25–29 is considered overweight, and 30 and higher is considered obese. The risk of health problems like diabetes, heart disease, and some cancers goes up with BMI, so maintaining a healthy body weight is good for your health. If you are overweight you should lose weight, even if you don’t achieve a BMI of less than 25.

30 is for 30 minutes of exercise per day. In addition to being as active as possible throughout the day, you should dedicate a minimum of 30 minutes for exercise or other activity. Considerable research shows that as little as 30 minutes of moderate to vigorous activity leads to improved fitness and health with greater benefits coming from longer duration or higher intensity activity. This can include exercise—a brisk walk or jog, lifting weights, or other aerobic exercise—as well as other activities like housework and yard work. Your goal should be to sit as little as possible, move as much as possible, and make time each day to be active.